Midterm Exam CP II

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174 Terms

1

biopsychosocial model

an individual’s health status is determined by the interplay of the person’s status in the biological, psychological, and social domains

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2

ICF model

used to describe the patient’s state of illness and disability, helps to classify the components and magnitude of the patient’s level of health, and provides a standard language and framework that enables the collection of data for practice and research; how we describe a person and their lived experience

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3

health condition

an individual’s involved pathology, disorder or disease process

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4

body functions and structures

an individual’s anatomic and physiologic features of the body

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5

impairments

an individual’s specific problem area or abnormality likely associated with the health condition

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6

activities

the specific tasks and actions executed by the individual

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7

limitations

constraints in performance of functional tasks

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8

participation

an individual’s involvement in life situations like socially defined roles

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9

restrictions

limited ability to participate - often related to socially defined roles

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10

contextual factors

the entire background of an individual’s life and living situation and it’s broken into environment and personal factors

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11

environmental factors

involves factors associated with the physical, social, and attitudinal environment that affect the experiences of an individual; example: having access to a vehicle or having stairs

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12

personal factors

involves features of the individual that are not part of the health condition (such as age, race, gender, lifestyle habits, etc.); stress, anxiety, and mental health fall into this category

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13

best available evidence, clinical expertise, and patient or client values and circumstances

the three components of evidence-based practice

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14

examination, evaluation, diagnosis, prognosis, intervention, outcomes

the six elements of the patient/client management model

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15

examination

gather data

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16

evaluation

correlate/interpret data

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17

diagnosis

label for an impairment

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18

prognosis

level of change; time frame

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19

intervention

treatment/plan of care/interaction

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20

outcomes

measured before and after (baseline vs. post intervention)

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21

history (outcome measures and review of systems), systems review, and special tests and outcome measures

the three major components of the PT examination

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22

history

part of PT examination that is subjective and most of the information comes directly from the patient; it is a systemic gathering of data both past and present related to why the patient is seeking PT services

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23

outcome measure

measures baseline performance, quantifies change, and provides information on effectiveness of interventions; can be general or specific to body region, health condition, or the individual; can be both objective and subjective depending on the type of data collected

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24

self-report

a type of outcome measure that requires the patient to complete a standard form or survey; limitation: patient may choose more favorable answers rather than responding with the truth (survey bias)

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25

performance-based test

a type of outcome measure that involves clinician observation of a patient during the performance of an activity to assess what a patient can do under very specific (controlled) circumstances

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26

review of systems

this is a component of the history-gathering phase in which the clinician seeks info about all major body systems; it is a subjective screen that can be done as a chart review, intake form, or patient interview

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27

signs of serious pathology, cauda equina, fracture, tumor, sudden weight loss, unremitting pain

red flags found during the history and review of systems that indicate a patient should be referred

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28

psychological risk factors (depression, anxiety, and unhelpful beliefs about pain), social and environmental risk factors (belief activity will hurt them/fear avoidance behaviors), coping strategies

yellow flags found during the history and review of systems that indicate the clinician should proceed with caution during treatment

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29

hypothesis and patient function

what should guide the PT objective exam

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30

during and at the end of the subjective exam - after history and review of systems

when should a PT begin generating hypotheses

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31

red flags, yellow flags, intake/other questionnaires, outcome measures, and PT related impairments

what should be considered when generating a hypothesis

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32

screening is more general (abnormal vs normal); special testing is more specific to the problem

difference b/t screening and special testing

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33

systems review

an objective screening that involves a brief, limited examination; likely involves the screening of cognition/communication, cardiopulm system, integumentary system, GI and genitourinary systems, musculoskeletal system, neuromuscular system, or functional mobility

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34

PT diagnosis, prognosis, goal setting, plan of care (interventions), and outcomes

the five major components of the PT evaluation

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35

PT diagnosis

component of PT evaluation that is a label to identify the impact of a condition on function at the movement system level; this is the primary dysfunction of the physical therapy intervention

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36

muscle performance, cardiopulmonary/endurance, mobility/flexibility, neuromuscular control/coordination, stability, balance/postural equilibrium, and pain

the seven impairment categories

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37

muscle performance

impairment category in which the patient has impaired AROM but full PROM, would test using a MMT, and patient would report feeling weak/limbs feeling heavy

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38

balance/postural equilibrium

impairment category that involves the patient having repeated falls, stumbling, using assistive devices, or holding onto walls/furniture

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39

stability

impairment category that involves physiological instability at the joints or structural integrity issues, patient may have dislocations/subluxation, hypermobility, or osteoporosis

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40

neuromuscular control/coordination

impairment category that indicates the brain is disconnected from the muscles, muscle coordination and muscle activation are affected; could be caused by stroke, SCI, Parkinson’s disease, etc.

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41

mobility/flexibility

impairment category that involves PROM issues and tightness; would be assessed using goniometry or inclinometry

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42

pain

this impairment category can influence all other categories and could potentially mask the primary impairment/hides the root cause of the problem

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43

cardiopulmonary/endurance

impairment category in which the patient experiences shortness of breath, abnormal vitals signs, and fatigues fast; patient could report having a history of cardiac or pulmonary problems or could be diagnosed with cardiac or pulmonary disorders (poor circulation related to CVD could potentially be put in this category)

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44

prognosis

component of the PT evaluation that uses evaluation results, pre-existing and current health status, and psychosocial factors to predict the optimum level of improvement on function and the predicted amount of time needed to reach that level

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45

mobility/flexibility definition

the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain free ROM

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46

contracture, prolonged immobilization, sedentary lifestyle, postural asymmetry or malalignment, dysfunctional neuromuscular control

factors that may contribute to hypomobility

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47

functional excursion

term for the distance from max elongation to max shortening

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48

active insufficiency

term for the point at which the agonist muscle can no longer shorten

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49

passive insufficiency

term for the point at which the antagonist can not be elongated without damage

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50

PROM

term for motion produced by an external force (no muscle contraction)

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51

AROM

term for motion produced directly by contraction of muscles (agonist)

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52

active-assistive ROM (AAROM)

term for motion produced by both contraction of muscles (agonist) and external force

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53

establish limitations of motion, determine joint mobility and end-feel, evaluate flexibility of soft-tissue structures, determine patient’s level of reactivity, assists with determination of patient’s irritability

indications for PROM exam

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54

establish limitations of motion, evaluate flexibility of soft-tissue structures, begin the process of establishing the patient’s strength (mm performance), assists with determination of patient’s irritability

indications for AAROM and AROM exam

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55

when mm contraction or motion of the body part could disrupt the healing process or could cause injury or deterioration of the condition

contraindications for ROM exam

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56

painful conditions, patient taking pain medications or mm relaxants, osteoporosis/bone fragility, hypermobility, hemophilia, in a region of a hematoma (especially in knee, hip, and elbow), bony ankylosis, after injury where soft tissue is disrupted, region of recently healed fx

precautions for ROM exam

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57

AROM

gross ROM exam that is tested first and involves quantity (ROM), quality (performance and willingness to move), and irritability (symptom provocation and time for recovery)

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58

PROM

gross ROM exam that is tested second and involves quantity (ROM), quality (end feel), reactivity (determining when symptoms are provoked), irritability (symptom provocation and time for recovery), and tone assessment (if indicated)

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59

hard end-feel

end feel created by bone-to-bone contact

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60

firm end feel

end feel created by muscular, capsular, or ligamentous stretch

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61

soft end feel

end feel created by soft-tissue approximation

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62

empty end feel

abnormal end feel that indicates the end of ROM was not reached due to pain/fear/anxiety/etc.; no resistance is felt except for the patient’s protective mm guarding or mm spasm

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63

reactivity

this is documented as reports of pain

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64

high reactivity

this is reports of pain prior to the therapist encountering end feel

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65

moderate reactivity

this is reports of pain as the therapist encounters the beginning of the end feel

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66

low reactivity

this is reports of pain as the therapist has encountered full range and end feel

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67

irritability

this is documented as a patient’s level of symptom provocation and time for recovery; the vigor of activity required to provoke symptoms and the time it takes for those symptoms to subside once aggravated

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68

maximal irritability

ratio of 1:2 or greater of aggravating activity to easing activity or rest; very little tolerance to activity and require significant time/effort to recover

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69

moderate irritability

ratio of 1:1 of aggravating activity to easing activity or rest; moderate tolerance to activity, may increase symptoms that return to baseline with periods of rest or relieving motions of the same length of time as it took to bring symptoms on

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70

minimal irritability

ratio of at least 2:1 of aggravating activity to easing activity or rest; high tolerance to activities, many repetitions or able to sustain a posture for a long time before symptoms appear, symptoms ease quickly with stopping activity or changing positions

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71

functional

ultimately, it is __________ movement patterns that should direct clinical decision making

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72

strength, power, and mm endurance

the three factors that contribute to muscle performance

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73

strength

this is the ability of contractile tissue to produce a force

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74

power

this is the ability to work per unit of time

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75

muscle endurance

this is the ability to work over extended periods of time

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76

when mm contraction or motion of the body part could disrupt the healing process and when mm contraction or motion of the body part could cause injury or deterioration of the condition

the two key contraindications for mm performance exams

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77

5

MMT grade: antigravity, full movement + tolerates strong pressure

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78

4

MMT grade: antigravity, full movement + tolerates moderate pressure

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79

3+

MMT grade: antigravity, full movement + tolerates some/minimal pressure

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80

3

MMT grade: antigravity, full movement only

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81

3-

MMT grade: antigravity, movement > ½ and < full

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82

2+

MMT grade: antigravity, movement < ½ full range

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83

2+

MMT grade: gravity eliminated, movement = full range + tolerates some pressure

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84

2

MMT grade: gravity eliminated, movement = full range

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85

2-

MMT grade: gravity eliminated, movement < full range

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86

1

MMT grade: any, palpable contraction

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87

0

MMT grade: any, no mm contraction

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88

function

what is the primary focus of all therapeutic interventions

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89

SAFETY, primary impairment category, ICF model, HIAPEP, evidence based practice, body mechanics, factors regarding person, task, and environment, SAFETY

these are the general principles in therapeutic intervention

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90

environment, intertrial variability, body, and manipulation

the four key components of Gentile’s Taxonomy

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91

>2-3 days/week with daily the most effective (3-4 weeks of regular training required

FITT dosing: stretching frequency

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92

stretch to the point of resistance/tightness/slight discomfort

FITT dosing: stretch intensity

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93

10-30 sec reps for most adults that should add up to at least 1 min of total stretch time, 30-60 sec reps for older adults

FITT dosing: stretch time

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94

static, ballistic, PNF, passive, assisted, etc.

FITT dosing: stretch type

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95

1-RM test

test used to establish a baseline mm performance; it is used for dosing

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96

Borg’s Scale or Modified Borg Scale (RPE)

this is used as an alternative to the 1-RM test to gauge exercise intensity

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97

rest intervals: 30-90 sec b/t each set, recovery: 48 hr b/t training sessions

recommended rest interval and recovery for strength training

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98

rest interval: 2-5 min b/t each set, recovery: 48 hr b/t training sessions

recommended rest interval and recovery for power training

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99

rest interval: <30 sec b/t each set, recovery: 48 hr b/t training sessions

recommended rest interval and recovery for endurance training

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100

functional

Maximize performance and order of exercises targeting primary __________ goal

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